The American Cancer Society has added blood-based screening tests to its list of recommended choices for adults age 45 and older who are at average risk for colorectal cancer and who have not completed or have declined visual exams and stool tests.
The change comes as colorectal cancer cases have surged in recent years, with a study by the Canadian Medical Association Journal on April 13 found that colorectal cancer is among four cancers estimated to account for 47 per cent of all new cancer cases in the country for 2026.
The American Cancer Society stated that blood-based screenings should only be used when a patient is not willing to get a stool-based test or visual exam.
Dr. Yoo-Joung Ko, a medical oncologist at St. Michael’s Hospital, said blood-based screening can be an easier option on patients.
“From a patient perspective, having a single blood test is often easier than having a colonoscopy,” he said. “The prep for a colonoscopy takes a better part of a day, and then the colonoscopy takes probably half a day in terms of patient commitment.”
Filomena Servidio-Italiano, president and CEO of Colorectal Cancer Resource & Action Network, said that “a simple blood draw is very appealing to Canadians who are at average risk of developing colorectal cancer” and “may increase participation in screening programs because there are no fasting or diet changes required.”
Barry D. Stein, president and CEO of Colorectal Cancer Canada, also welcomed the recommendation from the American society, even if Canadian provinces haven’t changed their screening guidelines.
“The more tools you can put in the toolbox, the better,” he said. “We are going in the direction where we hope one day to see a perfect blood test that can pick up not just colorectal cancer but all cancers.”
Eleven per cent of Canadian men are estimated to be diagnosed with colorectal cancer in 2026, with that number being nine per cent for Canadian women. Colorectal cancer is also expected to account for 10 per cent of cancer related deaths for both Canadian men and women.
P.E.I. became the first province to lower its colorectal cancer screening age to 45 on March 30 following calls from the Canadian Cancer Society and Colorectal Cancer Canada for all provinces to make the move as a growing number of people are diagnosed with colorectal cancer before the current routine screening age of 50.
They said people under 50 are two- to two-and-a-half times more likely to be diagnosed with colorectal cancer than they were in previous generations.
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April 2026 research from the Journal of the Canadian Association of Gastroenterology also states that to curb this growing trend, lowering the start age to 45 would result in over 15,000 fewer colorectal cancer cases and 6,100 fewer deaths over the next 45 years.
So far, Ontario is the only province to follow suit, while Nunavut confirmed to Global News on March 31 that its plans to make the same change.
Nova Scotia, New Brunswick, Alberta and Saskatchewan previously told Global News they are each reviewing recommendations, with Saskatchewan’s ColonCheck assessing evidence and the timeline to decrease the eligibility age.
Manitoba, Quebec, the Northwest Territories and Newfoundland and Labrador also previously said they are continuing to review evidence, though no changes are coming at this time.
“We hope to have a few other provinces on board by the end of the year, hopefully about four or five other ones as well,” Stein said.
Servidio-Italiano also highlighted additional work that needs to be done before implementing blood-based screening in Canada.
Ko believes that Canada would be in a good position to adapt to similar recommendations.
“Canada has a very rigorous process that can address changes in policy in terms of tests, as well as who to screen and what to screen for. So, we’re well prepared to consider anything like this, in an evidence-informed fashion,” he said.
The Canadian Cancer Society recommends that those between the ages of 45 to 74 and not at high risk for colorectal cancer have a stool test every two years.
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